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EP2353553B1 - Implant et système de distribution doté de plusieurs verrouillages de marqueur - Google Patents

Implant et système de distribution doté de plusieurs verrouillages de marqueur Download PDF

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Publication number
EP2353553B1
EP2353553B1 EP11165189.9A EP11165189A EP2353553B1 EP 2353553 B1 EP2353553 B1 EP 2353553B1 EP 11165189 A EP11165189 A EP 11165189A EP 2353553 B1 EP2353553 B1 EP 2353553B1
Authority
EP
European Patent Office
Prior art keywords
stent
implant
inner member
interlock structure
delivery system
Prior art date
Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
Active
Application number
EP11165189.9A
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German (de)
English (en)
Other versions
EP2353553A2 (fr
EP2353553A3 (fr
Inventor
Lixiao Wang
Jianlu Ma
Joe Tatalovich
Peggy Waltz
Keith Smythe
Rich Kusleika
Current Assignee (The listed assignees may be inaccurate. Google has not performed a legal analysis and makes no representation or warranty as to the accuracy of the list.)
Covidien LP
Original Assignee
Covidien LP
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Application filed by Covidien LP filed Critical Covidien LP
Publication of EP2353553A2 publication Critical patent/EP2353553A2/fr
Publication of EP2353553A3 publication Critical patent/EP2353553A3/fr
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Publication of EP2353553B1 publication Critical patent/EP2353553B1/fr
Active legal-status Critical Current
Anticipated expiration legal-status Critical

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    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/95—Instruments specially adapted for placement or removal of stents or stent-grafts
    • A61F2/962—Instruments specially adapted for placement or removal of stents or stent-grafts having an outer sleeve
    • A61F2/966—Instruments specially adapted for placement or removal of stents or stent-grafts having an outer sleeve with relative longitudinal movement between outer sleeve and prosthesis, e.g. using a push rod
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/82—Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/86—Stents in a form characterised by the wire-like elements; Stents in the form characterised by a net-like or mesh-like structure
    • A61F2/90—Stents in a form characterised by the wire-like elements; Stents in the form characterised by a net-like or mesh-like structure characterised by a net-like or mesh-like structure
    • A61F2/91—Stents in a form characterised by the wire-like elements; Stents in the form characterised by a net-like or mesh-like structure characterised by a net-like or mesh-like structure made from perforated sheets or tubes, e.g. perforated by laser cuts or etched holes
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/82—Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/86—Stents in a form characterised by the wire-like elements; Stents in the form characterised by a net-like or mesh-like structure
    • A61F2/90—Stents in a form characterised by the wire-like elements; Stents in the form characterised by a net-like or mesh-like structure characterised by a net-like or mesh-like structure
    • A61F2/91—Stents in a form characterised by the wire-like elements; Stents in the form characterised by a net-like or mesh-like structure characterised by a net-like or mesh-like structure made from perforated sheets or tubes, e.g. perforated by laser cuts or etched holes
    • A61F2/915—Stents in a form characterised by the wire-like elements; Stents in the form characterised by a net-like or mesh-like structure characterised by a net-like or mesh-like structure made from perforated sheets or tubes, e.g. perforated by laser cuts or etched holes with bands having a meander structure, adjacent bands being connected to each other
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/95—Instruments specially adapted for placement or removal of stents or stent-grafts
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/95—Instruments specially adapted for placement or removal of stents or stent-grafts
    • A61F2/9522—Means for mounting a stent or stent-graft onto or into a placement instrument
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/82—Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/86—Stents in a form characterised by the wire-like elements; Stents in the form characterised by a net-like or mesh-like structure
    • A61F2/90—Stents in a form characterised by the wire-like elements; Stents in the form characterised by a net-like or mesh-like structure characterised by a net-like or mesh-like structure
    • A61F2/91—Stents in a form characterised by the wire-like elements; Stents in the form characterised by a net-like or mesh-like structure characterised by a net-like or mesh-like structure made from perforated sheets or tubes, e.g. perforated by laser cuts or etched holes
    • A61F2/915—Stents in a form characterised by the wire-like elements; Stents in the form characterised by a net-like or mesh-like structure characterised by a net-like or mesh-like structure made from perforated sheets or tubes, e.g. perforated by laser cuts or etched holes with bands having a meander structure, adjacent bands being connected to each other
    • A61F2002/91533—Stents in a form characterised by the wire-like elements; Stents in the form characterised by a net-like or mesh-like structure characterised by a net-like or mesh-like structure made from perforated sheets or tubes, e.g. perforated by laser cuts or etched holes with bands having a meander structure, adjacent bands being connected to each other characterised by the phase between adjacent bands
    • A61F2002/91541—Adjacent bands are arranged out of phase
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/82—Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/86—Stents in a form characterised by the wire-like elements; Stents in the form characterised by a net-like or mesh-like structure
    • A61F2/90—Stents in a form characterised by the wire-like elements; Stents in the form characterised by a net-like or mesh-like structure characterised by a net-like or mesh-like structure
    • A61F2/91—Stents in a form characterised by the wire-like elements; Stents in the form characterised by a net-like or mesh-like structure characterised by a net-like or mesh-like structure made from perforated sheets or tubes, e.g. perforated by laser cuts or etched holes
    • A61F2/915—Stents in a form characterised by the wire-like elements; Stents in the form characterised by a net-like or mesh-like structure characterised by a net-like or mesh-like structure made from perforated sheets or tubes, e.g. perforated by laser cuts or etched holes with bands having a meander structure, adjacent bands being connected to each other
    • A61F2002/9155—Adjacent bands being connected to each other
    • A61F2002/91558—Adjacent bands being connected to each other connected peak to peak
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/82—Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/86—Stents in a form characterised by the wire-like elements; Stents in the form characterised by a net-like or mesh-like structure
    • A61F2/90—Stents in a form characterised by the wire-like elements; Stents in the form characterised by a net-like or mesh-like structure characterised by a net-like or mesh-like structure
    • A61F2/91—Stents in a form characterised by the wire-like elements; Stents in the form characterised by a net-like or mesh-like structure characterised by a net-like or mesh-like structure made from perforated sheets or tubes, e.g. perforated by laser cuts or etched holes
    • A61F2/915—Stents in a form characterised by the wire-like elements; Stents in the form characterised by a net-like or mesh-like structure characterised by a net-like or mesh-like structure made from perforated sheets or tubes, e.g. perforated by laser cuts or etched holes with bands having a meander structure, adjacent bands being connected to each other
    • A61F2002/9155—Adjacent bands being connected to each other
    • A61F2002/91591—Locking connectors, e.g. using male-female connections
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/95—Instruments specially adapted for placement or removal of stents or stent-grafts
    • A61F2/962—Instruments specially adapted for placement or removal of stents or stent-grafts having an outer sleeve
    • A61F2/966—Instruments specially adapted for placement or removal of stents or stent-grafts having an outer sleeve with relative longitudinal movement between outer sleeve and prosthesis, e.g. using a push rod
    • A61F2002/9665—Instruments specially adapted for placement or removal of stents or stent-grafts having an outer sleeve with relative longitudinal movement between outer sleeve and prosthesis, e.g. using a push rod with additional retaining means
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2220/00—Fixations or connections for prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof
    • A61F2220/0025—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements
    • A61F2220/005—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements using adhesives
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2220/00—Fixations or connections for prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof
    • A61F2220/0025—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements
    • A61F2220/0058—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements soldered or brazed or welded
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2230/00—Geometry of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof
    • A61F2230/0002—Two-dimensional shapes, e.g. cross-sections
    • A61F2230/0028—Shapes in the form of latin or greek characters
    • A61F2230/0054—V-shaped
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2250/00—Special features of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof
    • A61F2250/0058—Additional features; Implant or prostheses properties not otherwise provided for
    • A61F2250/0096—Markers and sensors for detecting a position or changes of a position of an implant, e.g. RF sensors, ultrasound markers
    • A61F2250/0098—Markers and sensors for detecting a position or changes of a position of an implant, e.g. RF sensors, ultrasound markers radio-opaque, e.g. radio-opaque markers

Definitions

  • the present invention relates to a system for delivering an implants to a site in a body lumen. More particularly, this invention pertains to a delivery system for a vascular implant such as a self-expanding stent.
  • One delivery technique for a self expanding device such as a stent, covered stent, stent graft, or mesh covered stent is to mount the collapsed device on a distal end of a device delivery system.
  • a device delivery system can be comprised of an outer tubular member and an inner tubular member.
  • the inner and outer tubular members are axially slideable relative to one another.
  • the device in the collapsed state
  • the outer tubular member also called the outer sheath
  • One or more portions of the device are releasably attached to the inner tubular member by means of interlock assemblies and the interlock assemblies facilitate proper positioning and control of the device during device deployment.
  • EP0696447 (CARDIOVASCULAR CONCEPTS), WO2006/026377 (COOK INCORPORATED), US2004/0204749 (GUNDERSON ) and WO00/71058 (SCIMED LIFE SYSTEMS each disclose prior art stent delivery systems.
  • system for delivering a medical device within a body lumen comprises: a tubular catheter having an outer shaft member slidably disposed about an inner shaft member; a medical device comprising a tubular, self-expanding section carried by the inner shaft member and disposed intermediate the inner shaft member and the outer shaft member, the implant having a length I and a constrained diameter d which frictionally engages an inner surface of the outer shaft member; and a tensioning mechanism for causing tensioning of the medical device when the outer shaft member moves relative to the inner shaft member.
  • Figures 1-3 show an over-the-wire device delivery system, in this example stent delivery system 10 having distal and proximal ends 11, 13, inner member 14, and retractable outer sheath 16 that slides over inner member 14.
  • Stent mounting location 26 is located adjacent distal end 11 of system 10.
  • Stent 12 (visible in Figures 2 and 3 ) is carried at stent mounting location 26 of stent delivery system 10 in a collapsed (or reduced diameter) state. Stent 12 mounts over inner member 14 and is covered by sheath 16 so as to be retained in the collapsed state (see Figure 2 ).
  • Stent 12 is released (i.e., deployed) by retracting sheath 16 to uncover or expose stent 12 (see Figure 3 ).
  • Distal end 11 of system 10 includes a tapered and flexible distal tip member 30 that is sufficiently flexible to permit advancement of stent deployment system 10 through the patient's lumen while minimizing trauma to the walls of the patient's lumen.
  • Tip 30 is connected to inner member 14 adjacent stent mounting location 26.
  • Proximal end 13 of system 10 includes manifold housing 20 connected to lock housing 22.
  • Sheath 16 connects to manifold housing 20.
  • Strain relief jacket 24 surrounds sheath 16 adjacent its connection to housing 20 to provide strain relief for sheath 18.
  • Inner member 14 passes through both manifold housing 20 and lock housing 22.
  • Outer reinforcing member 32 surrounds and is bonded to inner member 14 adjacent proximal end 13 of system 10.
  • Reinforcing member 32 may be made of a relatively rigid material such as stainless steel.
  • Port housing 34 is bonded to reinforcing member 32.
  • Port housing 34 has a bore aligned with an inner lumen of inner member 14 and functions to facilitate access to the inner lumen.
  • First and second handles 37, 39 are secured to lock housing 22 and reinforcing member 32, respectively- In the transport position, handles 37 and 39 are spaced apart and sheath 16 covers stent mounting location 26 to prevent premature deployment of stent 12.
  • handles 37 and 39 are moved toward each other, sheath 16 slides rearwardly or proximally relative to inner member 14.
  • relative axial movement between handles 37 and 39 results in relative axial movement between inner member 14 and sheath 16.
  • sheath 16 slides rearwardly from the transport position to the deploy position to fully expose stent mounting location 26 and permit stent 12 to freely expand toward its fully expanded diameter. After such expansion, the stent delivery system can be proximally withdrawn through the expanded stent and removed.
  • delivery system 10 is comprised of an interlock configuration (e.g., interlock structures 27, 28, or 29 of Figures 2 and 3 ) that constrains relative axial movement between stent 12 and inner member 14 until after sheath 16 has been retracted.
  • an interlock configuration e.g., interlock structures 27, 28, or 29 of Figures 2 and 3
  • a proximal interlock geometry located at a proximal end 12a of stent 12 interlocks with proximal interlock structure 27 adjacent the stent mounting location 26
  • a mid interlock geometry located at one or more locations along length of stent 12 interlocks with a mid interlock structure 28 adjacent the stent mounting location 26
  • a distal interlock geometry located at a distal end 12b of stent 12 interlocks with a distal interlock structure 29 adjacent the stent mounting location 26.
  • Figures 4A - 4G illustrate examples of improved inner members. For clarity only one layer of reinforcement structures are shown (in phantom) in the Figures, and hidden lines for matrix components are not shown.
  • Figure 4B illustrates inner member 14b having reinforcing strands 42b embedded within matrix 44.
  • Reinforcing strands 42b may be comprised of metal including but not limited to stainless steel, Elgiloy, superelastic alloys including Nitinol, gold, tantalum, tungsten, platinum, metallic glasses, and other metals; may be comprised of polymer including but not limited to PEEK, Liquid Crystal, polyester, Kevlar, polyamide, polyimide, and other polymers.
  • inner member 14b is comprised of 24 reinforcing strands.
  • One, two, three, or more layers of reinforcing strands may be used.
  • Matrix 44 may be comprised of polymer including but not limited to thermoplastics, thermosets, polyethylene, polypropylene, fluoropolymers such as FEP or PTFE, PEEK, Liquid Crystal, polyester, Kevlar, polyamide, polyimide, and other polymers- Matrix 44 may be comprised of one or more layers, and the one or more layers may be bonded together.
  • Figure 4C illustrates inner layer 44x and outer layer 44y bonded to each other and to reinforcing strands 42c. Some or all of matrix layers and reinforcing strands may be bonded to each other using adhesive, solvent, heat, ultrasonic vibration, laser energy, radiofrequency energy, or other means.
  • a stent delivery system having improved inner member can deliver and deploy a 150mm stent. In another embodiment, a stent delivery system having improved inner member can deliver and deploy a 180mm stent. In another embodiment, a stent delivery system having improved inner member can delivery and deploy a 200mm stent. In another embodiment, a stent delivery system having improved inner member can deliver and deploy a 250mm stent. In another embodiment, a stent delivery system having improved inner member can deliver and deploy a 300mm stent.
  • Rapid exchange stent delivery system 60 includes sheath 66 and inner member 64 disposed within sheath.
  • Manifold housing 70 is coupled to sheath 66.
  • Housing 70 includes side arm 72 and locking member 74.
  • Push wire 68 is coupled to inner member 64 at its distal end and to handle 80 at its proximal end.
  • Inner member 64 and sheath 66 are axially slideable relative to one another.
  • Push wire 68 and housing 70 are used to facilitate movement of inner member 64 relative to sheath 66.
  • Locking member 74 can be operated to couple housing 70 to push wire 68 in order to slide both sections along together.
  • a guidewire is percutaneously inserted into a patents blood vessel and advanced to a region of interest in the patient's body.
  • imaging techniques such as fluoroscopy a diseased portion of the vessel is identified and a stent having the correct length and diameter for treating the diseased portion is chosen.
  • self expanding medical device delivery system 10, 60 loaded with stent 12 is advanced over the guidewire to the treatment site and by using imaging techniques such as fluoroscopy stent 12 is positioned at a correct location relative to the treatment site.
  • the markers can be coated with a radiopaque material or filled with radiopaque material.
  • Materials for making ultrasonic marker 15 should have an acoustical density sufficiently different from stent 12 to provide suitable visualization through ultrasonic techniques.
  • Exemplary materials comprise polymers (for metallic stents), metals such as tantalum, platinum, gold, tungsten and alloys of such metals (for polymeric or ceramic stents), hollow glass spheres or microspheres, and other materials.
  • Materials for making MRI safe marker 15 should be non-ferrous and have a magnetic signature sufficiently different from stent 12 to provide suitable visualization through MRI techniques.
  • Exemplary materials comprise polymers (for metallic stents), metals such as tantalum, platinum, gold, tungsten and alloys of such metals (for polymeric or ceramic stents), and other materials.
  • stent-retaining structures having interlocks formed as an integral/unitary structure with the inner member.
  • stent retainers in the form of separate pieces can be secured to inner member 14.
  • retainers 14y, 14z can be machined, etched, stamped, formed, or otherwise fabricated into the surface of a ring of metal, engineering polymer, ceramic, or other material and the ring applied to inner member 14-19 by adhesive bonding, welding, solvent welding, fusing, or other techniques known in the art.
  • FIGS 9 and 9A illustrate an alternative embodiment of stent mid interlock geometry 28.
  • Stent 12 is comprised of retainers 12y in the form of pockets or voids in the compressed stent structure.
  • One or more protrusion 14x emanate from inner member 14 and in another embodiment are integral to and fixedly attached to inner member 14 adjacent mounting location 26.
  • protrusion 14x can be bonded, crimped, swaged, affixed, fastened, fused, molded in, embedded in, raised from or otherwise secured to inner member 14.
  • mid interlock geometry 28 is applied to stent 12 and inner member 14 in between proximal end 12a and distal end 12b of stent 12 at one or more locations along the length of the stent.
  • Figures 9 and 9A illustrate retainers 12y and protrusions 14x in an interlocked configuration.
  • Bioabsorbable ribbons 111 can be polymeric, bio-polymeric, ceramic, bio-ceramic, or metallic, or may be made from combinations of these materials. Bioabsorbable and non-bioabsorbable ribbons 111 may elute over time substances such as drugs.
  • the stencil stranded in figures 10 and 11 may be modified to include any of the interlock configurations described herein, one of which is illustrated in Figure 5C . It is contemplated that the interlock geometries and configurations described herein may be implemented with various stent types and designs, in addition to those disclosed herein.
  • Figure 14 illustrates stent 140 having interlock structures that interlock with interlock geometry of a delivery catheter, comprised of ribbon 111 having expandable architecture 142.
  • Expandable architecture 142 is comprised of enlarged ends 47, mid-stent retainer pockets 12y, struts 86, bend regions 19, and one or more interconnection regions 113. Struts 86 and bend regions 19 together form a zig-zag shaped expandable architecture of ribbon 111.
  • Other expandable architectures are contemplated for expandable architecture of ribbon 111 such as various serpentine or meandering paths.
  • Interconnection regions 113 join adjacent ribbons 111 and can fracture in a controlled manner such that when fractured, interconnection regions 113 no longer join adjacent ribbons 111.
  • Interconnection regions 113 are comprised interdigitating ends 118 in bend regions 19. Interdigitating ends 118 join together adjacent ribbons 111 by mechanical interference against each other when stent 150 is contracted. Upon expansion of stent 150 interdigitating ends 118 become separated along circumference of stent 150 such that adjacent ribbons 111 are no longer joined together. Many other interdigitating end geometries beyond that illustrated are possible provided the functional requirements of ends 118 are met, as will be apparent to those skilled in the art.
  • Figure 16 illustrates another example of an expandable architecture 130.
  • Expandable architecture 130 is comprised of cells 18, enlarged ends 47, mid-stent retainer pockets 12y, struts 86, bend regions 19, and one or more interconnection regions 113.
  • Struts 86 and bend regions 19 together form a cellular expandable architecture of ribbon 111 with similarities to the cellular structures described in connection with at least Figures 2, 3 , 5 , 7 , 8 , 10, 11 and 12 .
  • Interconnection regions 113 join adjacent ribbons 111 and can fracture in a controlled manner such that when fractured, interconnection regions 113 no longer join adjacent ribbons 111.
  • Interconnection regions 113 may be comprised of expanded ends 116 and receiver ends 117, interdigitating ends 118, or other structures.
  • FIGS 19 and 19A illustrate an alternative embodiment of stent mid interlock geometry 28.
  • Stent 180 is comprised of retainers 14y in the form of one or more pockets in interlock band 186.
  • Interlock band is preferably comprised of metal having machined, etched, formed, or stamped pockets, although other constructions are possible, as is known in the art.
  • Stent bend regions 19 may have extended ends 184 with angled geometry that interlocks with retainer pockets.
  • interlock band 186 is fixedly attached to inner member 14.
  • band 186 can be bonded, crimped, swaged, affixed, fastened, fused, molded in, embedded in, or otherwise secured to inner member 14.
  • FIGS 20, 20A and 20B illustrate an alternative embodiment of stent mid interlock geometry 28.
  • Stent 180 is comprised of retainers 12y in the form of spaces between compressed stent struts 86.
  • One or more ridges 192 emanate from inner member 14 and in a one embodiment are integral to and fixedly attached to inner member 14.
  • ridge 192 can be bonded, crimped, swaged, affixed, fastened, fused, molded in, embedded in, or otherwise secured to inner member 14.
  • ridges 192 are inserted into spaces between compressed stent struts 86 and axial motion of stent 190 relative to inner member 14 is prevented thereby.
  • FIGS. 22 and 22A illustrate an alternative embodiment of stent mid interlock geometry 28.
  • Stent 210 is comprised of retainers 12w in the form of one or more cavities 212 on stent struts 86.
  • Inner member 14 is comprises d of one or more mesa's 214 and in a one embodiment mesa's 214 are integral to and fixedly attached to inner member 14.
  • mesa's 214 can be bonded, crimped, swaged, affixed, fastened, fused, molded in, embedded in, or otherwise secured to inner member 14.
  • When stent 210 is compressed onto inner member 14 mesa's 214 substantially fill cavities 212 and axial motion of stent 210 relative to inner member 14 is prevented thereby.
  • mid interlock geometry 28 is applied to stent 12 and inner member 14 in between proximal end (not shown) and distal end (not shown) of stent 210 at one or more locations along the length of the stent.
  • Figures 22 and 22A illustrate mesa's 214 and cavities 212 in an interlocked configuration. When stent is expanded mesa's 214 move away radially from inner member 14 thereby removing mesa's 214 from cavities 212 and releasing interlock 28.
  • the stent is covered by the loading tube except for the distal interlock structure 26 which is left projecting outside of the end of the loading tube.
  • the inner member 14, 64 of stent delivery catheter 10, 60 having interlock structure is extended outside of sheath 16, 66 of said stent delivery catheter and the compressed stent in loading tube is slid over inner member 14, 64.
  • Distal stent and stent delivery catheter interlocks are connected and the loading tube is slid over the connected distal interlocks to expose proximal interlock structure 27 of the stent 12.
  • Proximal stent and stent delivery catheter interlocks are connected and the sheath is slid over the connected proximal interlocks.
  • the stent loading tube is withdrawn a short distance to expose a portion of the stent and the sheath is advanced to cover the exposed portion.
  • mid interlock structures 28, if used, are connected.
  • Stent length after loading is also close to stent length prior to loading in a system having mid or distal interlocks. In prior art devices without mid or distal interlocks stent length after loading can be as little as 90% of stent length prior to loading. In a one embodiment of a stent system having inventive interlocks, stent length after loading is 95 - 105% of stent length prior to loading In another more embodiment of a stent system having inventive interlocks, stent length after loading is 98 - 102% of stent length prior to loading. In another more embodiment of a stent system having inventive interlocks, stent length after loading is 99 - 101% of stent length prior to loading.
  • a guidewire is percutaneously inserted into a patient's blood vessel and advanced to a region of interest in the patient's body.
  • imaging techniques such as fluoroscopy the diseased portion of the vessel is identified and a stent having the correct length and diameter for a treatment site is chosen.
  • Inner member 14, 64 is held stationary and sheath 16, 66 is withdrawn to exposed stent 12.
  • Stent 12 expands into contact with a lumenal wall of the vessel as sheath 16, 66 is withdrawn.
  • Distal interlock 26 prevents stent from shortening due to axial compression when sheath 16, 66 is withdrawn, thereby facilitating deployment of distal end 12b of expanded stent at the correct location and reducing forces required to withdraw sheath 16, 66.
  • Mid interlocks 28 (if used) prevent stent from compressing axially when sheath 16, 66 is withdrawn thereby reducing forces required to withdraw sheath 16, 66.
  • Proximal interlocks 27 secure stent to stent delivery catheter until sheath 16, 66 is withdrawn proximally to stent end 12a, thereby thereby reducing forces required to withdraw sheath 16, 66 and facilitating deployment of proximal end 12a of expanded stent at the correct location.
  • stent markers 15 are imaged for various reasons including evaluating deployed stent position relative to treatment site, evaluating extent of stent diametrical expansion, and other reasons.
  • the various embodiments of the present invention have related to a stent and a stent delivery system, the scope of the present invention is not so limited.
  • the various aspects of the present invention are also applicable to systems for delivering other types of expandable implants.
  • other types of expanding implants include anastomosis devices, blood filters, grafts, vena cava filters, percutaneous valves, aneurism treatment devices, or other devices.
  • a system for delivering an implant within a body lumen comprising:
  • the tension mechanism comprises:
  • the implant comprises:
  • the tension mechanism comprises:
  • the tension mechanism comprises:
  • the implant comprises:

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  • Health & Medical Sciences (AREA)
  • Engineering & Computer Science (AREA)
  • Biomedical Technology (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Cardiology (AREA)
  • Oral & Maxillofacial Surgery (AREA)
  • Transplantation (AREA)
  • Veterinary Medicine (AREA)
  • Vascular Medicine (AREA)
  • Public Health (AREA)
  • Animal Behavior & Ethology (AREA)
  • General Health & Medical Sciences (AREA)
  • Optics & Photonics (AREA)
  • Physics & Mathematics (AREA)
  • Media Introduction/Drainage Providing Device (AREA)
  • Prostheses (AREA)

Claims (14)

  1. Système de distribution d'un implant (12) à l'intérieur d'une lumière corporelle comprenant :
    un cathéter tubulaire (10) comprenant un élément intérieur (14) et une gaine externe (16) mobile autour de l'élément intérieur (14),
    un implant (12) comprenant une section auto-extensible tubulaire, l'implant (12) ayant une extrémité proximale (12A) et une extrémité distale (12B), et un diamètre contraint d ; et
    caractérisé en ce qu'il comprend en outre :
    une structure de verrouillage d'extrémité (27, 29) pour le couplage en coopération avec l'une des extrémités proximale ou distale (12A, 12B) de l'implant (12) ; et
    une structure de verrouillage d'extrémité (28), la structure de verrouillage intermédiaire (28) et la structure de verrouillage d'extrémité (27, 29) coopérant afin d'empêcher le déploiement prématuré de l'implant (12) lorsque la gaine externe (16) bouge relativement à l'élément intérieur (14) tout en permettant des variations du diamètre contraint d de l'implant (12).
  2. Système de distribution d'implant selon la revendication 1, dans lequel l'implant (12) comprend :
    une pluralité de supports (86) ayant des extrémités terminales (72), au moins certaines des extrémités terminales (72) définissant un premier profil ; et
    dans lequel la structure de verrouillage d'extrémité (27, 29) comprend au moins un socle (14Y) définissant un second profil, sensiblement similaire au premier profil d'une extrémité terminale (72).
  3. Système de distribution d'implant selon l'une quelconque des revendications précédentes, dans lequel l'implant (12) est dimensionné pour engager par friction une surface interne de la gaine externe (16) lorsque dans le diamètre contraint d et tandis que la gaine externe (16) bouge relativement à l'élément intérieur (14).
  4. Système de distribution d'implant selon l'une quelconque des revendications précédentes, dans lequel l'implant (12) comprend :
    une pluralité de supports (86) ayant des extrémités terminales (72), au moins certaines des extrémités terminales (72) définissant un premier profil ; et
    dans lequel la structure de verrouillage d'extrémité (27, 29) comprend au moins un socle (14Y) définissant un second profil, différent du premier profil, pour recevoir les augmentations d'une longueur contrainte 1 de l'implant (12) lorsque la gaine externe (16) bouge relativement à l'élément intérieur (14).
  5. Système de distribution d'implant selon l'une quelconque des revendications précédentes, dans lequel la structure de verrouillage d'extrémité (27, 29) comprend au moins un socle (14Y) pour recevoir plusieurs extrémités terminales (72) de l'implant (12).
  6. Système de distribution d'implant selon l'une quelconque des revendications 4 ou 5, dans lequel ledit au moins un socle (14Y) définit un canal ayant une profondeur D mesurable le long d'un axe commun de l'élément intérieur (14) et de l'implant (12) ; et
    dans lequel la profondeur D est au moins égale à l'une quelconque des augmentations de la longueur contrainte 1 de l'implant (12) lorsque la gaine externe (16) bouge relativement à l'élément intérieur (14).
  7. Système de distribution d'implant selon l'une quelconque des revendications précédentes, dans lequel la structure de verrouillage intermédiaire (28) comprend :
    au moins une saillie (14X) ; et
    dans lequel au moins une poche (12Y) est définie à l'intérieur de l'implant (12) pour recevoir ladite au moins une saillie (14X) de la structure de verrouillage intermédiaire (28).
  8. Système de distribution d'implant selon l'une quelconque des revendications précédentes 1 à 6, dans lequel la structure de verrouillage intermédiaire (28) comprend :
    au moins une fiche (14Z) ; et
    dans lequel au moins un orifice est défini à l'intérieur de l'implant (12) pour recevoir ladite au moins une broche (14Z) de la structure de verrouillage intermédiaire (28).
  9. Système de distribution d'implant selon l'une quelconque des revendications précédentes 1 à 6, dans lequel la structure de verrouillage intermédiaire (28) comprend une bande de verrouillage (186).
  10. Système de distribution d'implant selon l'une quelconque des revendications précédentes 1 à 6, dans lequel la structure de verrouillage intermédiaire (28) comprend :
    au moins une arête (14X) ; et
    dans lequel au moins un espace (12Y) est défini à l'intérieur de l'implant (12) pour recevoir ladite au moins une arête (14X) de la structure de verrouillage intermédiaire (28).
  11. Système de distribution d'implant selon l'une quelconque des revendications précédentes 1 à 6, dans lequel la structure de verrouillage intermédiaire (28) comprend :
    au moins une bosse (202) ; et
    dans lequel au moins une motte (204) est définie à l'intérieur de l'implant (12) pour recevoir ladite au moins une bosse (202) de la structure de verrouillage intermédiaire (28).
  12. Système de distribution d'implant selon l'une quelconque des revendications précédentes 1 à 6, dans lequel la structure de verrouillage intermédiaire (28) comprend :
    au moins un plateau (214) ; et
    dans lequel au moins une cavité (212) est définie à l'intérieur de l'implant (12) pour recevoir ledit au moins un plateau (212) de la structure de verrouillage intermédiaire (28).
  13. Système de distribution d'implant selon l'une quelconque des revendications précédentes, comprenant à la fois une structure de verrouillage proximale (27) et une structure de verrouillage distale (29), la structure de verrouillage proximale (27) pouvant être couplée en coopération avec l'extrémité proximale (12A) de l'implant (12) et la structure de verrouillage distale (29) pouvant être couplée en coopération avec l'extrémité distale (12B) de l'implant (12).
  14. Système de distribution d'implant selon la revendication 13, dans lequel la structure de verrouillage proximale (27) et la structure de verrouillage distale (29) sont montées sur l'élément intérieur (14).
EP11165189.9A 2006-05-12 2007-05-14 Implant et système de distribution doté de plusieurs verrouillages de marqueur Active EP2353553B1 (fr)

Applications Claiming Priority (5)

Application Number Priority Date Filing Date Title
US80010606P 2006-05-12 2006-05-12
US86917206P 2006-12-08 2006-12-08
US89159607P 2007-02-26 2007-02-26
EP07783733A EP2020964B1 (fr) 2006-05-12 2007-05-14 Système de mise en place d'implant pourvu de verrouillages à marqueurs multiples
EP10195028.5A EP2301487B1 (fr) 2006-05-12 2007-05-14 Implant et système de distribution doté de plusieurs verrouillages de marqueur

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EP07783733.4 Division 2007-05-14
EP07783733A Division EP2020964B1 (fr) 2006-05-12 2007-05-14 Système de mise en place d'implant pourvu de verrouillages à marqueurs multiples
EP10195028.5A Division-Into EP2301487B1 (fr) 2006-05-12 2007-05-14 Implant et système de distribution doté de plusieurs verrouillages de marqueur
EP10195028.5A Division EP2301487B1 (fr) 2006-05-12 2007-05-14 Implant et système de distribution doté de plusieurs verrouillages de marqueur
EP10195028.5 Division 2010-12-14

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EP2353553A2 EP2353553A2 (fr) 2011-08-10
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EP07783733A Not-in-force EP2020964B1 (fr) 2006-05-12 2007-05-14 Système de mise en place d'implant pourvu de verrouillages à marqueurs multiples
EP11165189.9A Active EP2353553B1 (fr) 2006-05-12 2007-05-14 Implant et système de distribution doté de plusieurs verrouillages de marqueur

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EP07783733A Not-in-force EP2020964B1 (fr) 2006-05-12 2007-05-14 Système de mise en place d'implant pourvu de verrouillages à marqueurs multiples

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US (2) US9044351B2 (fr)
EP (3) EP2301487B1 (fr)
AT (1) ATE491417T1 (fr)
DE (1) DE602007011251D1 (fr)
ES (2) ES2562413T3 (fr)
WO (1) WO2007134290A2 (fr)

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DE602007011251D1 (de) 2011-01-27
EP2301487B1 (fr) 2014-09-17
WO2007134290A2 (fr) 2007-11-22
EP2020964A2 (fr) 2009-02-11
EP2301487A2 (fr) 2011-03-30
US9044351B2 (en) 2015-06-02
ES2562413T3 (es) 2016-03-04
EP2353553A2 (fr) 2011-08-10
US20070293930A1 (en) 2007-12-20
US10433992B2 (en) 2019-10-08
WO2007134290A3 (fr) 2008-01-17
EP2020964B1 (fr) 2010-12-15
ES2523990T3 (es) 2014-12-03
US20150265443A1 (en) 2015-09-24
EP2353553A3 (fr) 2012-07-11
ATE491417T1 (de) 2011-01-15
EP2301487A3 (fr) 2012-12-12
WO2007134290A8 (fr) 2014-03-20

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